title: Risk factors for intestinal ischaemia among patients registered in a UK primary care database: a nested case-control study.
abstract: BACKGROUND
  Intestinal ischaemia, including ischaemic colitis and acute mesenteric ischaemia, causes significant morbidity and mortality. Few population-based studies have estimated incidence and potential risk factors for this disease.
  
  
  OBJECTIVE
  To estimate the incidence of intestinal ischaemia and identify the associated risk factors in cohorts: (i) patients with irritable bowel syndrome and/or chronic constipation (IBS/CC/both), (ii) individuals free of these conditions.
  
  
  METHODS
  Population-based case-control analysis nested in a cohort of patients with first ever recorded diagnosis of IBS/CC/both and a cohort free of these conditions from general population using the General Practice Research Database.
  
  
  RESULTS
  Of 78 cases of intestinal ischaemia, 71 were from general population, seven from the IBS/CC/both cohort. Incidence rate of intestinal ischaemia in IBS/CC/both patients vs. general population was 4.49:1.09 per 100,000 person-years; age- and gender-adjusted incidence rate ratio (95% CI) was 2.7 (1.2-5.9). Inflammatory bowel disease and heart failure showed an association with ischaemic colitis [OR (95% CI): 4.2 (0.5-38.4) and 5.6 (2.2-14.1)], but none with acute mesenteric ischaemia. Diabetes and prior cardiovascular surgery were associated with higher risk of acute mesenteric ischaemia, but showed no association with ischaemic colitis.
  
  
  CONCLUSIONS
  Results suggest that different risk factors are associated with acute mesenteric ischaemia and ischaemic colitis. However, due to small number of patients, associations should be carefully interpreted.
authors.affiliation: Centro Español de Investigación Farmacoepidemiológica, Almirante 28, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Huerta
authors.forename: E
authors.initials: E
authors.lastname: Rivero
authors.forename: M A
authors.initials: MA
authors.lastname: Montoro
authors.forename: L A
authors.initials: LA
authors.lastname: García-Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017091:Colitis, Ischemic / Q000209:etiology*; D003248:Constipation / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007422:Intestines / Q000098:blood supply*; D043183:Irritable Bowel Syndrome / Q000453:epidemiology; D007511:Ischemia / Q000209:etiology*; D008297:Male; D065666:Mesenteric Ischemia; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014652:Vascular Diseases / Q000209:etiology